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17 Cards in this Set
- Front
- Back
Oxygen
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OXYGEN
INDICATIONS ♦ Acute Chest Pain ♦ Suspected hypoxemia of any cause or c/o SOB ♦ Cardiopulmonary Arrest Mechanism of Action Correct hypoxemia by O2 tension ↑ O2 content ↑ tissue oxygenation Precautions ♦ O2 Toxicity with high FIO2s ♦ May cause ↑CO2 if a CO2 retainer Dose ♦ 2 –6 LPM by NC for CP/mild distress ♦ NRB Mask for mod. Distress/ CHF ♦ Bag/Mask Ventilation ♦ Bag/ETT Ventilation or other advanced airway |
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Epinephrine
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EPINEPHRINE
Indications IVPush for ANY CARDIAC ARREST: ♦ Shock refractory VF & Pulseless VT ♦ Asystole ♦ PEA IVDrip for Symp Brady Mechanism of Action ↑ SVR, BP, HR, Contractility of heart, automaticity ↑ Bloodflow to heart & brain ↑ AV conduction velocity Precautions -none listed Dose CARDIAC ARREST: 1 mg IV Push (10 ml of 1:10,000 solution) Repeat 1 mg q 3-5” Endotracheal dose = 2-2.5 times IV dose SYMPTOMATIC BRADY: 2 – 10 mcg/min |
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vasopressin
(Pitressin®) |
**VASOPRESSIN**
INDICATIONS Alternative Pressor to EPI for ANY CARDIAC ARREST: ♦ VF/Pulseless VT ♦ Asystole ♦ PEA ♦ Can replace 1st or 2nd dose of EPI Also used for hemodynamic support in Septic Shock MOA Non-adrenergic Peripheral Vasoconstrictor ↑ Bloodflow to heart & brain PRECAUTIONS ♦ Half life = 10 – 20” ♦ Not recommended in CAD DOSE ♦ Any pulseless patient: 40 U IV single dose--1 time only ♦ To replace 1st or and dose of EPI ♦ ♦ ♦ Can defibrillate every 2 minutes after administration of Vasopressin ♦ Endotracheal dose = 2-2.5 times IV dose |
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Atropine
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**ATROPINE**
INDICATIONS ♦ Symptomatic Bradycardia ♦ Ventricular Asystole (2nd line) ♦ PEA if rate is brady (2nd line) MOA Parasympatholytic action: -accelerates rate of sinus node discharge -improves AV conduction PRECAUTIONS ♦ ↑ myocardial O2 demand: worsening ischemia DOSE Asystole or PEA 1 mg IV every 3-5” Bradycardia 0.5 mg every 3-5” Repeat to total dose of 0.04 mg/kg Endotracheal dose = 2-2.5 times IV dose |
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amiodarone
(Cordarone®) |
**AMIODARONE (CORDARONE)**
INDICATIONS ♦ VF/Pulseless VT (2nd line) ♦ Vent. Arrhythmias –Sympt PVCs ♦ Preferred over Lido MOA ♦Anti arrhythmic ♦Possesses α- and β- adrenergic blocking properties ♦Prolongs action potential duration ♦Prolongs refractory period ♦ ↓ AV node conduction ♦ ↓ sinus node function PRECAUTIONS ♦ Half life is long ♦ May prolongs QT Monitor BP, HR, QT interval CONTRAINDICATED IN: Cardiogenic shock, Marked Sinus Brady, 2nd or 3rd block DOSE ♦ 300 mg IV Push in cardiac arrest (VF/VT) ♦ 150 mg IV Push for tachys with pulse (give over 10min) ♦♦♦♦♦♦ Can repeat ONE 150 mg in 5 mins. Draw 2 glass ampules through a large gauge needle diluted in 20-30 mL of D5W Maintenance infusion: 1 mg/min over 6 hrs. then 0.5 mg/min over 18 hrs. – max of 2.2 g over 24 hrs. |
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Lidocaine
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**LIDOCAINE**
INDICATIONS Alternative to Amiodarone in: ♦ Vtach (with pulse – stable) ♦ VF/Pulseless VT (2nd line) ♦ Symptomatic PVCs MOA Suppresses vent ectopy ↑ VF threshold ↓ Vent. Irritability ↓ excitability Helps prevent VTach PRECAUTIONS ♦ CNS Toxicity: muscle twitching, slurred speech, resp. arrest, altered consciousness, seizures ♦ Prophylactic use in MI no longer recommended. DOSE ♦ For Vfib or Pulseless Vtach: 1 – 1.5 mg/kg repeat at 0.5 – 0.75 mg/kg in 3-5” for total dose of 3 mg/kg ♦ Vtach with pulse: 0.5 – 0.75 mg/kg repeat in 3-5” for total dose of 3 mg/kg ♦ Infusion: Infusion of 1-4 mg/min after termination of vent arrhythm. |
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Ibutilide
(Corvert®) |
**IBUTILIDE (CORVERT)**
INDICATIONS ♦ Rapid conversion of atrial fib or flutter of recent onset (< 48 hrs). MOA ♦ Prolongs action potential by delaying repolarization PRECAUTIONS ♦ Correct K & Mg before initiating Ibultilide DOSE ♦ > 60 kg: 1 mg over 10 min ♦ < 60 kg: 0.01 mg/kg over 10 min Can repeat with a 2nd dose |
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Procainamide
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**PROCAINAMIDE**
INDICATIONS ♦ Stable monomorphic VTach with Normal QT and Normal LV function ♦ SVT uncontrolled by Adenosine & vagal if stable BP ♦ Atrial Fib with rapid rate in WPW ♦ Stable wide complex Tachy of unknown origin MOA ♦ Supresses Ventricular Ectopy PRECAUTIONS ♦ Monitor BP for Hypotension ♦ Monitor ECG for ↑ PR and QT Intervals, QRS widening, & heart block ♦ Use with caution with Amiodarone (prolongation QT) DOSE ♦ 20 mg/min IV infusion ♦ urgent situations up to 50 mg/min (max 17 mg/kg) ♦ Stop if arrhythmia suppressed, ↓BP, or QRS duration ↑ by 50% ♦ Infusion: 1-4 mg/min |
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Magnesium SULFATE
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**MAGNESIUM SULFATE**
INDICATIONS ♦ Cardiac Arrest only if torsades is present or low Magnesium is suspected ♦ Life threatening vent arrhythmias due to dig tox. MOA ♦ Antiarrhythmic ♦ Restores electrolyte balance PRECAUTIONS ♦ Prophylactic use in MI no longer recommended ♦ ↓ dose with impaired liver or LV dysfunction DOSE ♦ For Cardiac Arrest due to low MG or Torsades 1-2 g/10 ml D5W Over 1-2” |
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Adenosine
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**ADENOSINE**
INDICATIONS ♦ Stable SVT ♦ Undefined stable narrow complex tachycardia as a diagnostic maneuver ♦ Not effective in Afib, Aflutter, or VTach MOA ♦ Depresses SA & AV node activity ♦ Slows AV conduction ♦ Half-life = 5 seconds PRECAUTIONS ♦ Usually see brief of asystole after adm of drug ♦ Drug interactions with Theophylline, Dipyridamole, & Carbamazepine ♦ Pts. feel flushing, dyspnea, transient CP DOSE ♦ 6 mg IV over 1 – 3 seconds followed by 20 cc saline flush then elevate arm (attach both syringes to same port) WAIT 1-2” ♦ Repeat 12 mg IV rapid push WAIT 1-2” ♦ Repeat 12 mg IV rapid push |
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Verapamil
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**VERAPAMIL**
INDICATIONS ♦ Alternative Drug after Adenosine for SVT MOA ♦ Systemic vasodilation ♦ Negative Inotropic effect ♦ Prolongs AV nodal conduction time ♦ Ca++ channel blocker PRECAUTIONS ♦ Expect ↓ BP – can counteract with IV Ca ♦ Do not use with wide complex DOSE 2.5 – 5.0mg IV bolus over 2 minutes 2nd dose: 5 – 10 mg in 15-30” |
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Digoxin
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**DIGOXIN**
INDICATIONS Slows ventricular response in ♦ Afib or Aflutter ♦ CHF MOA ♦ Inotropic effect ♦ Slows AV conduction PRECAUTIONS ♦ Toxic effects can cause serious arrhythmias DOSE 10 – 15 mcg/kg IV loading dose |
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Cardizem
(Diltiazem) |
**CARDIZEM (DILTIAZEM)**
INDICATIONS Controls vent rate in: ♦ Afib & Aflutter ♦ Refractory SVT (after Adenosine) MOA ♦ Ca++ channel blocker ♦ Prolongs effective refractory period PRECAUTIONS ♦ BP may ↓ ♦ DO NOT use for wide QRS Tachy, WPW with Afib, sick sinus syndrome, or β blockers DOSE ♦ 15-20 mg (0.25 mg/kg) IV over 2” May repeat in 15” at 20-25 mg (0.35mg/kg) over 2” ♦ Infusion 5-15 mg/h titrate to HR. |
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Morphine Sulfate
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**MORPHINE SULFATE**
INDICATIONS ♦ CP with ACS unresponsive to nitrates ♦ Cardiogenic Pul. Edema MOA ↓ Preload ↓ Afterload PRECAUTIONS ♦ Administer slowly and titrate to effect. ♦ Caution with RV infarction ♦ May cause ↓BP & Respiratory compromise – reverse with Narcan DOSE 2-4 mg IV (over 1-5 mins) every 5 to 30 minutes |
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Aspirin
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**ASPIRIN**
INDICATIONS ♦ All ACS MOA Prevents platelet aggregation PRECAUTIONS ♦ Contraindicated in acute ulcer disease, asthma, or ASA sensitivity. DOSE ♦ 160 mg to 325 mg tablet (chewing is preferable) – give immediately |
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Nitroglycerin
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**NITROGLYCERIN**
INDICATIONS ♦ Sublingual: Suspected ischemic pain ♦ IV Unstable Angina pectoris Acute MI CHF Hypertension MOA ♦ ↓ Pain in ischemic tissue ♦ ↑ Venous dilation ♦ ↓ Preload & O2 consumption ♦ Dilates Coronary Arteries ♦ ↑ Collateral flow in MI PRECAUTIONS Contraindicated with Hypotension BP < 90 or severe brady < 50. DOSE ♦Sublingual: 1 tablet (0.3-0.4 mg) – repeat Q5” ♦Spray: oral mucosa 1 – 2 sprays – repeat Q5” ♦Topical: 1-2” of 2% ointment |
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Sodium Bircarb
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**SODIUM BICARB**
INDICATIONS ♦ Pre-existing hyperkalemia ♦ Drug Overdose ♦ Known ketoacidosis ♦ Prolonged cardiac arrest with adequate ventilation PRECAUTIONS ♦ Adequate ventilation & CPR are best “buffer agents” DOSE 1 mEq/kg IV bolus |